When Patty Duke starred as rambunctious Patty Lane on her 1960s television show, and also played her more serious and subdued cousin, Cathy, little did she realize the double role would be a metaphor for her adult life.

	Robin Rombach, Post-Gazette Patty Duke speaks about bipolar disorder yesterday at Western Psychiatric Institute and Clinic in Oakland. Click photo for larger image.

Fifteen years after "The Patty Duke Show" went off the air in 1966, Ms. Duke was diagnosed with bipolar disorder, commonly known as manic depressive disorder. She traced the onset of the disorder back to age 19.

Now the Academy Award-winning actress serves as an international advocate for people suffering from the psychiatric disorder.

Her goal, she said yesterday during an appearance in Pittsburgh, is to remove its stigma, "stamp out the fear," and persuade people not only to seek treatment but maintain a treatment regimen the rest of their lives.

"What I've found after 25 years of reaching out to people is that there still is fear and ignorance about it," she said at a news conference at Western Psychiatric Institute and Clinic in Oakland.

Today Ms. Duke, 59, will present the keynote address, "A Brilliant Madness: Living with Manic Depressive Illness," during the conference "Effective Treatment of Affective Disorders: Partnership, Innovation and Promise," sponsored by the clinic.

The sold-out conference will be held 8 a.m. to 12:15 p.m. at the UPMC Cancer Pavilion in Shadyside.

Ms. Duke's talk, which bears the title of her book published in 1992, will focus on her "personal journey" with bipolar disorder. Her goal is to bring "a message of hope, healing, recovery and wellness to those in attendance."

After her speech, she will sign copies of her book.

"Every day was a new surprise," she said of the disorder. "It was very lonely. In the depression portion of the cycle, I would take to bed and cry. That's what I did for a month at a time. Then I had a level time, then an up time."

The manic period made her more energetic and impulsive but always with a feeling of foreboding.

"At times I was completely out of control, abusing my children and running through the neighborhood naked," she said. "But when it was time to go to work, I was ready. I hit my lines and did my job."

After work, she would revert back to questionable behavior. She said she suffered guilt during manic and depressive episodes.

In the end, she said, "I wanted the pain to stop. But I didn't want to die."

Dr. David J. Kupfer, Thomas Detre professor and chairman of the department of psychiatry and professor of neuroscience at the University of Pittsburgh School of Medicine, said bipolar disorder bears an annual societal cost exceeding $36 billion. "It's not the cost of the Iraq war, but when you think about it, that's a tremendous cost to society," Dr. Kupfer said.

Quoting a recent article in the American Journal of Psychiatry, he said people who suffer from depression miss 30 days of work each year. But bipolar disorder can double the number of sick days.

Bipolar disorder typically emerges in adolescence or early adulthood, although it can emerge in childhood or later in life. In 90 percent of patients, cycles of mania, depression or mixed symptoms of both recur and often become more frequent, disrupting work, school, family and social life.

The disease often is romanticized because it's been associated with highly creative people. But Dr. Kupfer said the consequences of no treatment are severe: The suicide rate among individuals with bipolar disorder is highest of any psychiatric illness.

Although the disorder's cause is unknown, a battery of drugs can be used to lessen its impact on people's lives. A genetic link has been established.

Dr. Kupfer described Ms. Duke as "a very big hero" because of her efforts to raise awareness of the disease and help those who suffer its impacts.

But the actress -- who starred on Broadway and television and won an Oscar in a supporting role as Helen Keller in the 1962 movie, "The Miracle Worker" -- said she's not the one working miracles here. She described Western Psych as "hallowed ground," where significant research is under way to figure out bipolar disorder.

"The research here boggles my mind," she said.